Publications

@article{Ma2024-lq,

title = {Pilot study on optimizing pressure for standardized capillary  refill time measurement},

author = {Zi-Yu Ma and Shen Sun and Shui-Cai Wu and Lan Lin and Yi-Xiong Chen and Dong Zhao and Stephen P Morgan},

doi = {10.1016/j.heliyon.2024.e35716},

year  = {2024},

date = {2024-08-01},

urldate = {2024-08-01},

journal = {Heliyon},

volume = {10},

number = {15},

pages = {e35716},

publisher = {Elsevier BV},

abstract = {Purpose: Capillary Refill Time (CRT) measurement has gained 

 increasing attention in the field of sepsis and septic shock. 

 Recognizing pressure as a fundamental determinant in CRT 

 measurement is crucial for establishing a standardized CRT 

 measurement procedure. In this preliminary study, we elucidated 

 the optimal pressing strength for CRT measurement by analyzing 

 the CRTs measured under varying pressures. Method: Seventeen 

 healthy individuals were enlisted to undergo CRT tests on their 

 fingertips at various pressure levels. The applied force was 

 initiated at 0.5N and incrementally increased by 0.5N until it 

 reached 10.5N. An integrated Photoplethysmography (PPG) device 

 was employed to capture fluctuations in light intensity. The CRT 

 was automatically derived from the PPG signals via a specialized 

 algorithm. The study included correlation assessment and 

 reliability evaluation. Box plot and Bland-Altman plot were used 

 to visualize the impact of pressure levels on CRTs. Results: A 

 dataset of 1414 CRTs across 21 pressures showed significant 

 differences (Kruskal-Wallis test, p \< 0.0001), highlighting the 

 impact of pressure on CRT. CRT values between 4.5N and 10.5N 

 pressures varied less, with an Intraclass Correlation 

 Coefficient (ICC) of 0.499 indicating moderate consistency. 

 Notably, CRTs at 10N and 10.5N pressures revealed a high ICC of 

 0.790, suggesting strong agreement. Conclusion: A pressure range 

 of 4.5N-10.5N is recommended for stable CRT measurements, with 

 10.0N-10.5N providing optimal consistency and reliability.},

keywords = {Capillary refill time, Microcirculation, Pressure, Sepsis, Septic shock},

pubstate = {published},

tppubtype = {article}

}